Breast Cancer – HESI Exam Questions with Correct Answers 100% Verified|
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What is the best response by the nurse? "To ensure your safety, I need to notify the surgeon
of the crackers you ate."
Which ethical principle has the greatest weight in the nurse's decision to inform Chandra's
surgeon about the snack? Nonmaleficence
The nurse confirms that Chandra has signed the informed consent for surgery, but learns that
Chandra does not understand the procedure for breast reconstruction that is to be performed.
What action should the nurse implement? Notify the surgeon that further explanation of
the procedure is necessary
After surgery, Chandra is admitted to the PACU for immediate postoperative management.
Which nursing actions have the highest priority in the initial postoperative period? (Select all
that apply.) Observe the Jackson-Pratt drainage device
Place head of the bed up at least 30 degrees with affected arm elevated on a pillow
Monitor vital signs and pulse oximetry
After Chandra is awake and stable, she is moved from the PACU to the regular post-op unit. The
nurse observes Chandra performing wrist flexion and extension exercises 4 hours after surgery.
What action should the nurse take? Encourage Chandra to continue performing these
exercises
, The nurse enters Chandra's room and observes that a graduate nurse is assessing Chandra's
dressing while the unlicensed assistive personnel (UAP) takes postoperative vital signs. The UAP
is preparing to take Chandra's BP on her operative side because there is an IV in the other arm.
Which action should the nurse implement first? Advise the UAP to immediately stop and
obtain the blood pressure in the nonoperative arm
The nurse is discussing the situation with the graduate nurse and UAP. What should the nurse
emphasize in the discussion? Both the graduate nurse and the UAP are at fault for the
incorrect action of the UAP
Chandra seems happy and she tells the nurse that she received some good news. She states
that her tumor was negative for estrogen receptor sites. She continues, "That means I have less
likelihood of a recurrence or spread of the cancer."
What action should the nurse take first? Ask Chandra to clarify how she learned this
information so that a plan for further teaching can be developed.
Since Chandra's tumor is estrogen-receptor negative, she is not a candidate for hormonal
therapy. Tamoxifen (Nolvadex) is an antiestrogen drug that is often used to prevent or treat
recurrent breast cancer. Chandra states that a friend of hers took this drug and has had no
recurrence of her breast cancer. The nurse asks Chandra if her friend experienced any problems
when taking Tamoxifen (Nolvadex).
Which side effect is most often associated with Tamoxifen? Hot flashes
Chandra is disappointed to learn that she will not benefit from hormonal therapy, but she
states that her friend indicated that taking the medication was like experience menopause.
How should the nurse respond? "The medication decreases estrogen levels, which is what
also causes the symptoms of menopause."
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What is the best response by the nurse? "To ensure your safety, I need to notify the surgeon
of the crackers you ate."
Which ethical principle has the greatest weight in the nurse's decision to inform Chandra's
surgeon about the snack? Nonmaleficence
The nurse confirms that Chandra has signed the informed consent for surgery, but learns that
Chandra does not understand the procedure for breast reconstruction that is to be performed.
What action should the nurse implement? Notify the surgeon that further explanation of
the procedure is necessary
After surgery, Chandra is admitted to the PACU for immediate postoperative management.
Which nursing actions have the highest priority in the initial postoperative period? (Select all
that apply.) Observe the Jackson-Pratt drainage device
Place head of the bed up at least 30 degrees with affected arm elevated on a pillow
Monitor vital signs and pulse oximetry
After Chandra is awake and stable, she is moved from the PACU to the regular post-op unit. The
nurse observes Chandra performing wrist flexion and extension exercises 4 hours after surgery.
What action should the nurse take? Encourage Chandra to continue performing these
exercises
, The nurse enters Chandra's room and observes that a graduate nurse is assessing Chandra's
dressing while the unlicensed assistive personnel (UAP) takes postoperative vital signs. The UAP
is preparing to take Chandra's BP on her operative side because there is an IV in the other arm.
Which action should the nurse implement first? Advise the UAP to immediately stop and
obtain the blood pressure in the nonoperative arm
The nurse is discussing the situation with the graduate nurse and UAP. What should the nurse
emphasize in the discussion? Both the graduate nurse and the UAP are at fault for the
incorrect action of the UAP
Chandra seems happy and she tells the nurse that she received some good news. She states
that her tumor was negative for estrogen receptor sites. She continues, "That means I have less
likelihood of a recurrence or spread of the cancer."
What action should the nurse take first? Ask Chandra to clarify how she learned this
information so that a plan for further teaching can be developed.
Since Chandra's tumor is estrogen-receptor negative, she is not a candidate for hormonal
therapy. Tamoxifen (Nolvadex) is an antiestrogen drug that is often used to prevent or treat
recurrent breast cancer. Chandra states that a friend of hers took this drug and has had no
recurrence of her breast cancer. The nurse asks Chandra if her friend experienced any problems
when taking Tamoxifen (Nolvadex).
Which side effect is most often associated with Tamoxifen? Hot flashes
Chandra is disappointed to learn that she will not benefit from hormonal therapy, but she
states that her friend indicated that taking the medication was like experience menopause.
How should the nurse respond? "The medication decreases estrogen levels, which is what
also causes the symptoms of menopause."
